Early predictors of anastomotic leaks after colectomy

Bellows, Charles F.; Webber, Larry S.; Albo, Daniel; Awad, Selmy; Berger, David H.

doi:10.1007/s10151-009-0457-7

Cited by 73 publications

(66 citation statements)

References 18 publications

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“…The AL rate after colorectal surgery varies between 1% and 40%, depending on the definition of leakage and on the type of resection performed, being higher in extraperitoneal anastomosis (Bellows et al, 2009). The rate of 7.6% in this study falls within the range of previously published series.…”

Section: Discussionmentioning

confidence: 99%

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Liu¹,

Huang²,

Zhou³

2013

Asian Pacific Journal of Cancer Prevention

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Purpose: To investigate the risk factors for anastomotic leakage (AL) after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Between January 2004 and December 2011, 753 consecutive patients in Jiangsu Cancer Hospital and Research Institute diagnosed with rectal cancer and undergoing anterior resection with a double stapling technique were recruited. All patients experienced a total mesorectal excision (TME) operation. Additionally, decrease of postoperative tumor supplied group of factors (TSGF), which have not been reported before, was proposed as a new indicator for AL. Univariate and multivariate analysis were performed to determine risk factors for AL. Results: AL was detected in 57 (7.6%) of 753 patients with rectal cancer. The diagnosis of anastomotic leakage was confirmed between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate analysis and multivariate analysis, age (p<0.001), gender (p=0.002), level of anastomosis (p < 0.001), preoperative body mass index (BMI) (p = 0.001) and reduction of TSGF in 5th POD was less than 10 m/ml (p < 0.001) were selected as 5 independent risk factors for AL. It was also indicated that a temporary defunctioning transverse ileostomy (p = 0.04) would decrease the occurrence of AL. Conclusion: AL after anterior resection for rectal carcinoma is related to elderly status, low level site of the tumor (below the peritoneal reflection), being male, preoperative BMI and the decrease of TSGF in 5 th POD is less than 10 m/ml. Preventive ileostomy is advisable after TME for low rectal tumors to prevent AL.

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Section: Discussionmentioning

confidence: 99%

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Liu¹,

Huang²,

Zhou³

2013

Asian Pacific Journal of Cancer Prevention

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“…4 With current screening and diagnostic methods, the interval between construction of the colorectal anastomosis and diagnosis of leakage varies between 6 and 13 days. [5][6][7] Several studies have suggested that delay of diagnosis of CAL is associated with higher mortality rates and that only early management improves clinical outcome. [8][9][10] Therefore, new screening methods allowing detection of CAL in the early postoperative phase are needed.…”

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confidence: 99%

Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage

Komen

Slieker

Willemsen

et al. 2014

The American Journal of Surgery

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BACKGROUND: We aim to determine if C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and procalcitonin (PCT) in drain fluid can serve as screening tools for colorectal anastomotic leakage (CAL).METHODS: Patients included in this multicenter prospective observational study underwent left hemicolectomy, sigmoid resection, high anterior resection, low anterior resection, or subtotal colectomy. During the first 5 postoperative days, CRP, LBP, and PCT were determined on drain fluid. RESULTS: In total 243 patients were included, of whom 19 (8%) developed CAL. CRP levels were higher in patients with leakage on day 3 and day 5, levels of LBP were higher on days 2, 3, and 4, and PCT levels were higher on day 5. Multivariate analysis showed LBP to be significantly related to CAL. An increase in the average initial value at the first postoperative day with 1 standard deviation increased the risk of leakage by 1.6 times.This research was made possible by grant from ''Stichting Technische Wetenschappen'' (STW), Utrecht, The Netherlands. STW had no role in the study design, in collection, analysis and interpretation of the data, in writing of this manuscript or in the decision to submit.

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“…The AL rate after colorectal surgery varies between on the type of resection performed, being higher in extraperitoneal anastomosis (Bellows et al, 2009). The rate of 7.6% in this study falls within the range of previously published series.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Based on Risk Assessment of Anastomotic Leakage after Rectal Cancer Surgery

Gong¹,

Liu²,

Huang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Early predictors of anastomotic leaks after colectomy

Abstract: The earliest clinical predictors of an anastomotic leak are pulmonary and/or neurological. Awareness of these findings might help in early diagnosis and treatment of an anastomotic leak.

Cited by 73 publications

References 18 publications

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Risk Assessment on Anastomotic Leakage after Rectal Cancer Surgery: An Analysis of 753 Patients

Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage

Outcomes Based on Risk Assessment of Anastomotic Leakage after Rectal Cancer Surgery

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